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Published on: November 12, 2021
Modified Laparoscopic Percutaneous Extraperitoneal Closure Using a Sledge-Shaped Needle for Inguinal Hernia and
Yongliang Hua1, Chaoqun Wang2, Shounan Lu2
1Department of Pediatric Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Insights
Modified laparoscopic percutaneous extraperitoneal closure (LPEC) is a safe and effective surgical technique for pediatric inguinal hernia and hydrocele. This study confirms its efficacy with low recurrence rates and good cosmetic outcomes.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Inguinal hernias and hydroceles are common pediatric surgical conditions.
- Traditional surgical approaches may have limitations.
- Laparoscopic techniques offer potential advantages in pediatric surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of a modified laparoscopic percutaneous extraperitoneal closure (LPEC) technique.
- To assess outcomes in pediatric patients undergoing LPEC for inguinal hernia or hydrocele.
- To analyze the impact of specific modifications on surgical results.
Main Methods:
- A retrospective study of pediatric patients who underwent modified LPEC from January 2014 to July 2018.
- Modification involved a sledge-shaped needle and reinforcement flag.
- Medial umbilical fold reinforcement was employed for large internal rings (>1.5 cm).
Main Results:
- 764 inguinal hernia and 435 hydrocele cases were successfully treated with modified LPEC.
- Contralateral patent processus vaginalis was identified and treated prophylactically in 50.1% of hernia and 61.1% of hydrocele cases.
- Hernia recurrence occurred in only 2 cases, with good cosmetic results and no additional dissection.
Conclusions:
- Modified LPEC, incorporating a sledge-shaped needle and medial umbilical fold reinforcement, is a safe and effective surgical procedure.
- The technique demonstrates low complication and recurrence rates in pediatric patients.
- This approach offers favorable cosmetic outcomes for treating inguinal hernia and hydrocele.
Background:
The objective of the study is to determine the safety and efficiency of the modified laparoscopic percutaneous extraperitoneal closure (LPEC) to treat pediatric patients with inguinal hernia or hydrocele.
Methods:
From January 2014 to July 2018, the patients with inguinal hernia or hydrocele who were operated on using modified LPEC were included. We modified LPEC with a sledge-shaped needle and reinforcement flag. By means of medial umbilical fold, the reinforcement surgery should be performed on the patients with huge internal rings (diameter >1.5 cm). Operative time, complication rate, incidence of reinforcement, and contralateral patent processus vaginalis were described between inguinal hernia and hydrocele.
Results:
In this study, 764 patients with inguinal hernia and 435 patients with hydrocele were successfully performed by the modified LPEC. The 383 (50.1%) patients with inguinal hernia and 266 (61.1%) patients with hydrocele were identified with a contralateral patency of internal ring and underwent simultaneous prophylactic surgery. During surgical procedures, the medial umbilical fold reinforcement (inguinal hernia/hydrocele = 50/1) was performed on 51 patients. Hernia recurrence occurred in 2 cases. All patients had a good cosmetic appearance without additional dissection.
Conclusion:
Modified LPEC using a sledge-shaped needle and applying the medial umbilical fold reinforcement is a safe and effective surgical procedure.
